RESUMO
BACKGROUND: The Active Connected Engaged [ACE] study is a multi-centre, pragmatic, two-arm, parallel-group randomised controlled trial [RCT] with an internal pilot phase. The ACE study incorporates a multi-level mixed methods process evaluation including a systems mapping approach and an economic evaluation. ACE aims to test the effectiveness and cost-effectiveness of a peer-volunteer led active ageing intervention designed to support older adults at risk of mobility disability to become more physically and socially active within their communities and to reduce or reverse, the progression of functional limitations associated with ageing. METHODS/DESIGN: Community-dwelling, older adults aged 65 years and older (n = 515), at risk of mobility disability due to reduced lower limb physical functioning (Short Physical Performance Battery (SPPB) score of 4-9 inclusive) will be recruited. Participants will be randomised to receive either a minimal control intervention or ACE, a 6-month programme underpinned by behaviour change theory, whereby peer volunteers are paired with participants and offer them individually tailored support to engage them in local physical and social activities to improve lower limb mobility and increase their physical activity. Outcome data will be collected at baseline, 6, 12 and 18 months. The primary outcome analysis (difference in SPPB score at 18 months) will be undertaken blinded to group allocation. Primary comparative analyses will be on an intention-to-treat (ITT) basis with due emphasis placed on confidence intervals. DISCUSSION: ACE is the largest, pragmatic, community-based randomised controlled trial in the UK to target this high-risk segment of the older population by mobilising community resources (peer volunteers). A programme that can successfully engage this population in sufficient activity to improve strength, coordination, balance and social connections would have a major impact on sustaining health and independence. ACE is also the first study of its kind to conduct a full economic and comprehensive process evaluation of this type of community-based intervention. If effective and cost-effective, the ACE intervention has strong potential to be implemented widely in the UK and elsewhere. TRIAL REGISTRATION: ISRCTN, ISRCTN17660493. Registered on 30 September 2021. Trial Sponsor: University of Birmingham, Contact: Dr Birgit Whitman, Head of Research Governance and Integrity; Email: researchgovernance@contacts.bham.ac.uk. Protocol Version 5 22/07/22.
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Envelhecimento , Exercício Físico , Idoso , Humanos , Análise Custo-Benefício , Estudos Multicêntricos como Assunto , Modalidades de Fisioterapia , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Voluntários , Ensaios Clínicos Pragmáticos como AssuntoRESUMO
Background: The prevention of mobility-related disability amongst adults is a global healthcare priority. Cost-effective community-based strategies to improve physical function and independence in older adults with mobility limitations are needed. This study investigated the effectiveness of the REtirement in ACTion (REACT) exercise intervention on individual markers of physical function at 6-and 12-months. Methods: The REACT multicentre randomised controlled trial assigned 777 older adults (female, 514; male 263) (mean age 77·6 [SD 6·8] years) with reduced lower limb physical functioning (Short Physical Performance Battery [SPPB] score 4-9) to receive brief healthy ageing advice or a 12-month, group-based, multimodal exercise programme delivered in local communities. Estimated differences in the three individual component scores of the SPPB (strength, balance, gait speed) and physical functional outcomes recorded at 6- and 12-months were assessed. Results: The intervention group demonstrated significant improvements in strength (OR = 1.88, 95% CI = 1.36-2.59, p < 0.001) and balance (OR = 1.96, 95% CI = 1.39-2.67, p < 0.001) at 12-months, but not in gait speed (OR = 1.32, 95% CI = 0.91-1.90, p = 0.139). In comparison to the control group, at six-and 12-months, the intervention group reported statistically significant improvements in Mobility Assessment Tool-Short Form (MAT-SF), physical component score from SF-36 questionnaire, and strength and endurance items of subjectively reported physical activity (PASE 10-item). Greater than 75% adherence (attending ≥48 of the 64 exercise sessions delivered in 12-months) was associated with superior functional outcomes. Conclusion: The REACT exercise programme provides local, regional and national service providers with an effective solution to increase muscle strength and balance in older adults at risk of mobility disability.
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Exercício Físico , Aposentadoria , Masculino , Humanos , Feminino , Exercício Físico/fisiologia , Modalidades de Fisioterapia , Acidentes por Quedas/prevenção & controle , Terapia por ExercícioRESUMO
Measures of stepping volume and rate are common outputs from wearable devices, such as accelerometers. It has been proposed that biomedical technologies, including accelerometers and their algorithms, should undergo rigorous verification as well as analytical and clinical validation to demonstrate that they are fit for purpose. The aim of this study was to use the V3 framework to assess the analytical and clinical validity of a wrist-worn measurement system of stepping volume and rate, formed by the GENEActiv accelerometer and GENEAcount step counting algorithm. The analytical validity was assessed by measuring the level of agreement between the wrist-worn system and a thigh-worn system (activPAL), the reference measure. The clinical validity was assessed by establishing the prospective association between the changes in stepping volume and rate with changes in physical function (SPPB score). The agreement of the thigh-worn reference system and the wrist-worn system was excellent for total daily steps (CCC = 0.88, 95% CI 0.83-0.91) and moderate for walking steps and faster-paced walking steps (CCC = 0.61, 95% CI 0.53-0.68 and 0.55, 95% CI 0.46-0.64, respectively). A higher number of total steps and faster paced-walking steps was consistently associated with better physical function. After 24 months, an increase of 1000 daily faster-paced walking steps was associated with a clinically meaningful increase in physical function (0.53 SPPB score, 95% CI 0.32-0.74). We have validated a digital susceptibility/risk biomarker-pfSTEP-that identifies an associated risk of low physical function in community-dwelling older adults using a wrist-worn accelerometer and its accompanying open-source step counting algorithm.
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Acelerometria , Dispositivos Eletrônicos Vestíveis , Vida Independente , Caminhada , Extremidade Inferior , PunhoRESUMO
BACKGROUND: Physical activity (PA) is beneficial for older adults' health, however they remain the least active age group in the UK. This qualitative longitudinal study aims to understand motivations in older adults receiving the REACT physical activity intervention, through the lens of self-determination theory. METHODS: Participants were older adults randomised to the intervention arm of the Retirement in ACTion (REACT) Study, a group-based physical activity and behaviour maintenance intervention to prevent decline of physical functioning in older adults (≥ 65 years). Stratified purposive sampling by physical functioning (Short Physical Performance Battery scores) and 3-month attendance was employed. Fifty-one semi-structured interviews were conducted at 6, 12 and 24-months with twenty-nine older adults (Mean age (baseline) = 77.9 years, SD 6.86, 69% female) and at 24-months with twelve session leaders and two service managers. Interviews were audio recorded, transcribed verbatim and analysed using Framework Analysis. RESULTS: Perceptions of autonomy, competence and relatedness were associated with adherence to the REACT programme and maintenance of an active lifestyle. Motivational processes and participants' support needs, changed during the 12-month REACT intervention and across the 12-months post-intervention. Group interactions were an important source of motivation during the first six months but increased competence and mobility drove motivation at the later stages (12 months) and post-intervention (24 months). CONCLUSIONS: Motivational support needs vary in different stages of a 12-month group-based programme (adoption and adherence) and post-intervention (long-term maintenance). Strategies to accommodate those needs include, (a) making exercise social and enjoyable, (b) understanding participants' capabilities and tailoring the programme accordingly, (c) capitalising on group support to motivate participants to try other activities and prepare sustainable active living plans. TRIAL REGISTRATION: The REACT study was a pragmatic multi-centre, two-arm, single-blind, parallel-group, RCT (ISRCTN registration number 45627165).
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Motivação , Aposentadoria , Humanos , Feminino , Idoso , Masculino , Limitação da Mobilidade , Estudos Longitudinais , Método Simples-Cego , Exercício FísicoRESUMO
BACKGROUND: The Cervical Radiculopathy Impact Scale (CRIS) and Patient Specific Functional Scale 2.0 (PSFS 2.0) are patient-reported outcome measures (PROMs) used to assess activity limitations in patients with cervical radiculopathy (CR). This study a) compared the CRIS subscale 3 and the PSFS 2.0 in patients with CR with respect to completeness and patient preference, b) established the correlation between both PROMs in assessing the individual patient's level of functional limitations and c) assessed the frequency of reported functional limitations. METHODS: Participants with CR participated in semi-structured, individual, face-to-face interviews as part of a "think-aloud" process; verbalising their thoughts while completing both PROMs. Sessions were digitally recorded and transcribed verbatim for analysis. RESULTS: Twenty-two patients were recruited. The most frequently reported functional limitation on the CRIS was: 'working at a computer' (n = 17) and overhead activities' (n = 10) for the PSFS 2.0. There was significant moderate positive correlation between the scores on the PSFS 2.0 and the CRIS (Spearman's r = 0.55, n = 22 p = .008). Most patients (n = 18; 82%) preferred the ability to present their own individual functional limitations of the PSFS 2.0. Eleven participants (50%) preferred the 11-point scale of the PSFS 2.0 over the 5-point Likert scale scoring option of the CRIS. CONCLUSION: Both easy to complete PROMs capture functional limitations in patients with CR. Most patients prefer the PSFS 2.0 over the CRIS. The wording and layout of both PROMs need refinement to enhance user-friendliness and avoid misinterpretation.
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Radiculopatia , Humanos , Radiculopatia/terapia , Medidas de Resultados Relatados pelo PacienteRESUMO
OBJECTIVE: We aimed to determine what older adults perceive to be need-supportive behaviours of peer walk leaders, drawing primarily from Self-Determination Theory (SDT). DESIGN: Experienced peer leaders (n = 13; Mage = 73.23, SD = 6.55) and walkers (n = 17; Mage = 72.88, SD = 5.79) were recruited from existing walking groups. Individuals who expressed an interest in becoming a peer leader (n = 18; Mage = 72.72, SD = 4.99) or walker (n = 20; Mage = 78.90, SD = 10.45) were recruited from retirement villages. MAIN OUTCOME MEASURES: We conducted semi-structured interviews to identify leader behaviours that support autonomy, competence, and relatedness and analysed the data using framework analysis. RESULTS: We identified eight main themes: eliciting walker interest, acknowledging and adapting to walkers' requirements, ensuring walkers feel comfortable, cared for, and socially integrated, supporting walker confidence, and promoting success experiences. Inexperienced leaders differed from other sub-groups in what they perceived to be supportive behaviours. CONCLUSION: Future peer leaders could use the identified behaviours to help older adults feel motivated during group walks. New peer leaders can be educated about potential differences between what they describe as supportive and what walkers and experienced leaders perceive as need-supportive behaviours.
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Motivação , Caminhada , Humanos , Idoso , Grupo Associado , Comportamento Sedentário , Autonomia PessoalRESUMO
Urban age-friendly initiatives strive to promote active and healthy ageing by addressing urban influences that impact individuals as they age. Collaborative community partnerships with multi-level stakeholders are crucial for fostering age-friendly initiatives that can transform urban community health. Employing a citizen social science (CSS) approach, this study aimed to engage older adults and stakeholders in Birmingham, UK, to (i) identify key urban barriers and facilitators to active and healthy ageing, and (ii) facilitate collaboration and knowledge production to lay the groundwork for a citizen science project. Older adults (n = 16; mean age = 72(7.5 SD); 11 female) and community stakeholders (n = 11; 7 female) were engaged in six online group discussions, with audio recordings transcribed and thematically analysed to present key urban barrier and facilitator themes. Ageism, winter, technology and safety were barriers identified by both groups. Outdoor spaces and infrastructure, transportation, community facilities, and Covid-19 pandemic were identified as barriers and/or facilitators. Older adults identified the ageing process as a barrier and diversity of the city, health and mobility and technology as facilitators. For stakeholders, barriers were deprivation and poverty, gender differences, and ethnicity, whereas age-inclusive activities were a facilitator. Organic and active opportunities for older adults and stakeholders to connect, co-produce knowledge on urban environments and share resources presented foundations of solution-building and future collaboration. CSS effectively facilitated a range of stakeholders across local urban spaces to collaborate and co-produce ideas and solutions for enhancing local urban environments to promote active and healthy ageing.
Planning urban age-friendly environments requires engagement with local residents, service providers and decision-makers. This is important for developing joint actions, urban initiatives and allowing these individuals to share their experiences, needs and resources. Citizen social science (CSS) can engage residents and stakeholders to directly shape social research aiming to improve urban environments. This study engaged 16 older adults over the age of 60 and 11 stakeholders to identify urban features that influence active and healthy ageing in Birmingham, UK. Using six online discussion groups, the key urban barriers and facilitators were identified by older adults and stakeholders, who also checked the findings to confirm they represent the discussions accurately. Urban barriers and facilitators included health and mobility, ageism, outdoor spaces and infrastructure, transportation, technology, Covid-19, and the lack or presence of community facilities and activities. During discussion groups, both older adults and stakeholders connected to share information about local organizations, resources, websites for free activities or research, and provide solutions for each other's barriers. CSS effectively engaged older adults and stakeholders to collaborate and create knowledge together for improving local urban environments in Birmingham.
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COVID-19 , Ciência do Cidadão , Envelhecimento Saudável , COVID-19/prevenção & controle , Feminino , Humanos , Pandemias , Meios de TransporteRESUMO
BACKGROUND: Fidelity assessment of behaviour change interventions is vital to understanding trial outcomes. This study assesses the delivery fidelity of behaviour change techniques used in the Retirement in ACTion (REACT) randomised controlled trial. REACT is a community-based physical activity (PA) and behaviour maintenance intervention to prevent decline of physical functioning in older adults (≥ 65 years) at high risk of mobility-related disability in the UK. METHODS: The delivery fidelity of intervention behaviour change techniques and delivery processes were assessed using multi-observer coding of purposively sampled in-vivo audio recordings (n = 25) of health behaviour maintenance sessions over 12-months. Delivery fidelity was scored using a modified Dreyfus scale (scores 0-5) to assess competence and completeness of delivery for each technique and delivery process. "Competent delivery" was defined as a score of 3 points or more for each item. Examples of competent intervention delivery were identified to inform recommendations for future programme delivery and training. RESULTS: The mean intervention fidelity score was 2.5 (SD 0.45) with delivery fidelity varying between techniques/processes and intervention groups. Person-centred delivery, Facilitating Enjoyment and Promoting Autonomy were delivered competently (scoring 3.0 or more). There was scope for improvement (score 2.0-2.9) in Monitoring Progress (Acknowledging and Reviewing), Self-Monitoring, Monitoring Progress (Eliciting Benefits of Physical Activity), Goal Setting and Action Planning, Modelling, Supporting Self-Efficacy for Physical Activity and Supporting Relatedness. Managing Setbacks and Problem Solving was delivered with low fidelity. Numerous examples of both good and sub-optimal practice were identified. CONCLUSIONS: This study highlights successes and improvements needed to enhance delivery fidelity in future implementation of the behavioural maintenance programme of the REACT intervention. Future training of REACT session leaders and assessment of delivery fidelity needs to focus on the delivery of Goal setting and Action Planning, Modelling, Supporting Relatedness, Supporting Self-Efficacy for Physical Activity, and Managing Setbacks/ Problem Solving.
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Limitação da Mobilidade , Aposentadoria , Idoso , Terapia Comportamental , Exercício Físico , Humanos , Vida IndependenteRESUMO
BACKGROUND: Physical activity interventions have had varying results on modifying hippocampal volume. METHODS: The Retirement in Action (REACT) study conducted a randomised-controlled trial of a 12-month physical activity and behaviour maintenance intervention in older adults at risk of mobility impairments. The physical activity sessions were delivered twice weekly for the first twelve weeks, and then reduced to once weekly, to groups of 15 participants. Activities included cardiovascular, strength, balance and flexibility exercises. A sub-sample of participants in the physical activity (N = 54) and control arms (N = 48) underwent a 3 T MRI brain scan and cognitive assessments at baseline, 6- and 12-months (mean age = 76.6 years, 6.8 SD). It was hypothesised that the intervention would lead to a reduced rate of decline in hippocampal volume. Group differences in changes in cognition were also examined. RESULTS: As hypothesised, we found a maintenance in left hippocampal volume in the intervention arm, in comparison with the control arm after 12 months (p = 0.027). In a secondary analysis, this effect was attenuated after including age, sex and education level as covariates (p = 0.057). There was no significant between-group difference in the right hippocampus (p = 0.405). Contrary to our hypothesis, we did not find a beneficial effect of the intervention on cognitive outcomes. CONCLUSIONS: Our findings suggest that a community-based physical activity intervention can significantly ward-off hippocampal atrophy in older adults. While the lack of effects on cognition may limit the interpretability of our results, our findings of hippocampal maintenance are promising given the potential clinical relevance of protecting the hippocampus from age-related decline.
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Terapia por Exercício , Exercício Físico , Idoso , Terapia Comportamental , Terapia por Exercício/métodos , Hipocampo/diagnóstico por imagem , Humanos , Imageamento por Ressonância MagnéticaRESUMO
BACKGROUND: Mobility limitations in older populations have a substantial impact on health outcomes, quality of life, and social care costs. The Retirement in Action (REACT) randomised controlled trial assessed a 12-month community-based group physical activity and behaviour maintenance intervention to help prevent decline in physical functioning in older adults at increased risk of mobility limitation. We aimed to do an economic evaluation of the REACT trial to investigate whether the intervention is cost-effective. METHODS: In this health economic evaluation, we did cost-effectiveness and cost-utility analyses of the REACT programme versus standard care on the basis of resource use, primary outcome, and health-related quality-of-life data measured in the REACT trial. We also developed a decision analytic Markov model that forecasts the mobility of recipients beyond the 24-month follow-up of the trial and translated this into future costs and potential benefit to health-related quality of life using the National Health Service and Personal Social Services perspective. Participants completed questionnaire booklets at baseline, and at 6, 12, and 24 months after randomisation, which included a resource use questionnaire and the EQ-5D-5L and 36-item short-form survey (SF-36) health-related quality-of-life instruments. The cost of delivering the intervention was estimated by identifying key resources, such as REACT session leader time, time of an individual to coordinate the programme, and venue hire. EQ-5D-5L and SF-36 responses were converted to preference-based utility values, which were used to estimate quality-adjusted life-years (QALYs) over the 24-month trial follow-up using the area-under-the-curve method. We used generalised linear models to examine the effect of the REACT programme on costs and QALYs and adjust for baseline covariates. Costs and QALYs beyond 12 months were discounted at 3·5% per year. This is a pre-planned analysis of the REACT trial; the trial itself is registered with ISRCTN (ISRCTN45627165). FINDINGS: The 12-month REACT programme was estimated to cost £622 per recipient to deliver. The most substantial cost components are the REACT session leader time (£309 per participant), venue hire (£109), and the REACT coordinator time (£80). The base-case analysis of the trial-based economic evaluation showed that reductions in health and social care usage due to the REACT programme could offset the REACT delivery costs (£3943 in the intervention group vs £4043 in the control group; difference: -£103 [95% CI -£695 to £489]) with a health benefit of 0·04 QALYs (0·009-0·071; 1·354 QALYs in the intervention group vs 1·314 QALYs in the control group) within the 24-month timeframe of the trial. INTERPRETATION: The REACT programme could be considered a cost-effective approach for improving the health-related quality of life of older adults at risk of mobility limitations. FUNDING: National Institute for Health Research Public Health Research Programme.
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Qualidade de Vida , Aposentadoria , Idoso , Análise Custo-Benefício , Exercício Físico , Humanos , Medicina EstatalRESUMO
BACKGROUND: Mobility limitations in old age can greatly reduce quality of life, generate substantial health and social care costs, and increase mortality. Through the Retirement in Action (REACT) trial, we aimed to establish whether a community-based active ageing intervention could prevent decline in lower limb physical functioning in older adults already at increased risk of mobility limitation. METHODS: In this pragmatic, multicentre, two-arm, single-blind, parallel-group, randomised, controlled trial, we recruited older adults (aged 65 years or older and who are not in full-time employment) with reduced lower limb physical functioning (Short Physical Performance Battery [SPPB] score 4-9) from 35 primary care practices across three sites (Bristol and Bath; Birmingham; and Devon) in England. Participants were randomly assigned to receive brief advice (three healthy ageing education sessions) or a 12-month, group-based, multimodal physical activity (64 1-h exercise sessions) and behavioural maintenance (21 45-min sessions) programme delivered by charity and community or leisure centre staff in local communities. Randomisation was stratified by site and adopted a minimisation approach to balance groups by age, sex, and SPPB score, using a centralised, online, randomisation algorithm. Researchers involved in data collection and analysis were masked but participants were not because of the nature of the intervention. The primary outcome was change in SPPB score at 24 months, analysed by intention to treat. This trial is registered with ISRCTN, ISRCTN45627165. FINDINGS: Between June 20, 2016, and Oct 30, 2017, 777 participants (mean age 77·6 [SD 6·8] years; 66% female; mean SPPB score 7·37 [1·56]) were randomly assigned to the intervention (n=410) and control (n=367) groups. Primary outcome data at 24 months were provided by 628 (81%) participants (294 in the control group and 334 in the intervention group). At the 24-month follow-up, the SPPB score (adjusted for baseline SPPB score, age, sex, study site, and exercise group) was significantly greater in the intervention group (mean 8·08 [SD 2·87]) than in the control group (mean 7·59 [2·61]), with an adjusted mean difference of 0·49 (95% CI 0·06-0·92; p=0·014), which is just below our predefined clinically meaningful difference of 0·50. One adverse event was related to the intervention; the most common unrelated adverse events were heart conditions, strokes, and falls. INTERPRETATION: For older adults at risk of mobility limitations, the REACT intervention showed that a 12-month physical activity and behavioural maintenance programme could help prevent decline in physical function over a 24-month period. FUNDING: National Institute for Health Research Public Health Research Programme (13/164/51).
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Qualidade de Vida , Aposentadoria , Idoso , Exercício Físico , Feminino , Humanos , Masculino , Limitação da Mobilidade , Método Simples-CegoRESUMO
As research and services in the Mediterranean region continue to increase, so do opportunities for global collaboration. To support such collaborations, the Alzheimer's Association was due to hold its seventh Alzheimer's Association International Conference Satellite Symposium in Athens, Greece in 2021. Due to the COVID-19 pandemic, the meeting was held virtually, which enabled attendees from around the world to hear about research efforts in Greece and the surrounding Mediterranean countries. Research updates spanned understanding the biology of, treatments for, and care of people with Alzheimer's disease (AD_ and other dementias. Researchers in the Mediterranean region have outlined the local epidemiology of AD and dementia, and have identified regional populations that may expedite genetic studies. Development of biomarkers is expected to aid early and accurate diagnosis. Numerous efforts have been made to develop culturally specific interventions to both reduce risk of dementia, and to improve quality of life for people living with dementia.
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Doença de Alzheimer , COVID-19 , Humanos , Doença de Alzheimer/epidemiologia , Doença de Alzheimer/terapia , Doença de Alzheimer/diagnóstico , Qualidade de Vida , Pandemias , BiomarcadoresRESUMO
By 2050, 20% of the world's population will be over the age of 65 years, with projections that 80% of older adults will be living in low- to middle-income countries. Physical inactivity and sedentary time are particularly high in older adults, presenting unique public health challenges. In this article, we first review evidence that points to multiple beneficial outcomes of active aging, including better physical function, cognitive function, mental health, social health, and sleep, and we suggest the need to shift the research focus from chronic disease outcomes to more relevantoutcomes that affect independence and quality of life. Second, we review the critical role of age-friendly environments in facilitating active aging equitably across different countries and cultures. Finally, we consider emerging opportunities related to social engagement and technology-enabled mobility that can facilitate active aging. In all these contexts, it is a priority to understand and address diversity within the global aging population.
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Saúde Pública , Qualidade de Vida , Idoso , Envelhecimento , Humanos , Saúde Mental , Comportamento SedentárioRESUMO
BACKGROUND: This mixed methods study explored how social media use informed physical activity and diet-related behaviours, and self-perceived Quality of Life (QoL) during COVID-19, and assessed the contextual factors that drive social media use for health-related behaviour change in diverse groups. During the COVID-19 lockdown periods there were reported changes to social media use and health behaviours, and this gave an opportunity to investigate potential relationships. METHODS: An explanatory sequential research design of two parts was used: (1) An online survey that assessed social media use in relation to physical activity levels, diet quality and QoL (n = 786; Mage 45.1 ± 19.1 (range 16-88) years; Female =69%); (2) 20 purposive focus groups (n = 69; Mage = 52.88 ± 18.45 years, Female n = 68%) to understand the contextual factors that drive social media use for health-related behaviour change. Descriptive and thematic analysis were conducted. RESULTS: Participants in this study reported that social media facilitated the self-management of behaviours related to physical activity, diet and QoL, through access to information to inform workouts and dietary quality, and the opportunities for interaction with peers, family members and within social groups. Contextual factors including work, home and lifestyle arrangements, pre-existing health-related knowledge and behaviours, and the perceived value of social media for health influenced the relationship between social media use and self-reported outcomes. Social media influencers, peers/family members, and official organisations influenced the application of health-related information accessed via social media. CONCLUSIONS: The evidence shows that participants were critical users of social media and were able to use social media to derive benefit for their health and wellbeing. Detailed guidance for those who use social media, as well as those who recommend and endorse social media content is required to maximise the potential of social media to support health behaviours. Future public health strategies and social media interventions should acknowledge diversity in contextual factors driving social media use for health behaviour change.
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COVID-19 , Mídias Sociais , Controle de Doenças Transmissíveis , Dieta , Exercício Físico , Feminino , Humanos , Masculino , Qualidade de Vida , SARS-CoV-2RESUMO
Objective: Loneliness and social isolation are associated with higher risk of morbidity and mortality and physical inactivity in older age. This study explored the socioecological context in which both physically active and inactive older adults experience loneliness and/or social isolation in a UK rural setting. Design: A mixed-methods design employed semi structured interviews and accelerometer-measured moderate-to-vigorous physical activity (MVPA). Interviews explored the personal, social and environmental factors influencing engagement with physical activities, guided by an adapted-socioecological model of physical activity behaviour. Findings: Twenty-four older adults (Mean Age = 73 (5.8 SD); 12 women) were interviewed. Transcripts were thematically analysed and seven profiles of physical activity, social isolation and loneliness were identified. The high-MVPA group had established PA habits, reported several sources of social contact and evaluated their physical environment as activity friendly. The low MVPA group had diverse experiences of past engagement in social activities. Similar to the high MVPA, they reported a range of sources of social contact but they did not perceive the physical environment as activity friendly. Conclusions: Loneliness and/or social isolation was reported by both physically active and inactive older adults. There is wide diversity and complexity in types and intensity of PA, loneliness and social isolation profiles and personal, social and environmental contexts.
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Solidão , Isolamento Social , Idoso , Inglaterra , Exercício Físico , Feminino , Humanos , Comportamento SedentárioRESUMO
BACKGROUND: Successful peer volunteering is central to many community-based, active ageing initiatives. This study synthesises the perspectives of a range of stakeholders involved in peer volunteering initiatives and provides recommendations as to how peer volunteers can be effectively mobilised as community assets. METHODS: An evidence synthesis of qualitative data from (a) the evaluation of ACE (Active, Connected, Engaged), a feasibility trial of a peer volunteering active ageing intervention, and (b) interviews with volunteers and managers of third sector organisations providing peer volunteering programmes. Data were analysed using directed content analysis. RESULTS: Ten managers, 22 volunteers and 20 ACE participants were interviewed. The analysis identified six main themes, 33 higher and 22 sub themes. Main themes were: (i) Motives, (ii) Benefits, (iii) Skills and Characteristics, (iv) Challenges, (v) Training Needs, (vi) Recruitment and Retention. Altruism, changes in life circumstances, opportunities to reconnect with the community and personal fulfilment were the main reasons for volunteering. Volunteering was described as being personally rewarding, an avenue to acquire new skills and knowledge, and an opportunity for increased social connections and physical activity. Good peer volunteers are committed, reliable, have a good sense of humour, good interpersonal skills and are able to relate to participants. When pairing volunteers with participants, shared interests and geographical proximity are important to consider. Clarity of role, level of time commitment, regular feedback, recognition of effort and strong networks for on-going support are important strategies to facilitate volunteer retention. CONCLUSIONS: The findings of this study support the value of peer volunteering as a strategy for mobilising community assets in promoting active ageing. To ensure success and longevity, these schemes require appropriate funding and efficient administrative support.
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Envelhecimento , Voluntários , Exercício Físico , Humanos , Grupo AssociadoRESUMO
STATEMENT OF PROBLEM: RED January is an annual social media campaign challenging individuals to be physically active every day during January, and highlighting the potential for improvements in mood and wellbeing. Our aim was to explore elements of the challenge that motivate engagement with, and sustained participation in, physical activity for mental health. METHOD: RED January registrants (n= 55,772, female = 45,802; 82%) were invited to take part. Volunteers supplied information on sex, age band and moderate-to-vigorous physical activity in the past week. Forty registrants (24 female), recruited in December 2019 using a purposive sampling approach to identify a maximum-variation sample, participated in semi-structured interviews (31 face-to-face) after completing the challenge. The resulting transcripts were thematically analysed, using the Framework method. RESULTS: Two main themes relating to motivation were identified. 'Pleasure' referred to how daily activity promoted physical enjoyment and positive affective states via engaging with the environment, finding mental space and peace, and enjoyable social interactions. 'Purpose' referred to the experiences of engaging with the campaign, and observed changes in health outcomes. These included setting flexible and appropriate goals, measuring and reviewing progress, noting wider biological and behavioural changes, and receiving support from the social media community. Points for consideration were feelings of failure when not achieving self-imposed targets, the unintended facilitation of obsessive exercising, and social media posts that triggered negative thoughts among a minority of participants. CONCLUSIONS: Findings suggest RED January may have potential as a public health resource. The challenge might not suit individuals with severe disorders.
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BACKGROUND AND OBJECTIVES: Peer volunteers offer a promising avenue for promoting physical activity in older adults. However, recruiting and retaining such volunteers are challenging. We aimed to examine longitudinally factors that determine whether older volunteer walk leaders will persist in their role. RESEARCH DESIGN AND METHODS: We recruited older adults volunteering as walk leaders, from retirement villages in Perth, at the start of a 16-week walking intervention. Using a mixed-methods multiple case study design, informed by self-determination theory, we examined the motivational processes of three profiles: Dropouts, Completers, and Extenders. One male and 10 female (medianAge = 75 years, age range: 66-83 years) peer walk leaders were interviewed twice over 4 months, and data were analyzed using thematic analysis. Questionnaires provided information on volunteer characteristics, leadership confidence, and volunteer motivation. RESULTS: Self-orientated goals, obligation and guilt, emotional exhaustion, lack of psychological need satisfaction, and perceived lack of support were barriers to volunteer persistence. Social confidence and relatedness satisfaction motivated volunteers to persist until program completion (Completers). Altruistic goals, using sustainable helping strategies, psychological need satisfaction, optimism, and enjoyment were important for continuing the role after the program (Extenders). DISCUSSION AND IMPLICATIONS: Results describe how differences in volunteer motives, personal characteristics, and training may affect motivational processes that determine persistence as an older peer walk leader. We provide suggestions on selecting, training, and supporting older volunteer walk leaders to facilitate their retention.
Assuntos
Motivação , Caminhada , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Grupo Associado , Satisfação Pessoal , VoluntáriosRESUMO
Recently revised public health guidelines acknowledge the health benefits of regular intermittent bouts of vigorous intensity incidental physical activity done as part of daily living, such as carrying shopping bags, walking uphill, and stair climbing. Despite this recognition and the advantages such lifestyle physical activity has over continuous vigorous intensity structured exercise, a scoping review we conducted revealed that current research in this area is, at best, rudimentary. Key gaps include the absence of an empirically-derived dose specification (e.g., minimum duration of lifestyle physical activity required to achieve absolute or relative vigorous intensity), lack of acceptable measurement standards, limited understanding of acute and chronic (adaptive) effects of intermittent vigorous bouts on health, and paucity of essential information necessary to develop feasible and scalable interventions (e.g., acceptability of this kind of physical activity by the public). To encourage collaboration and research agenda alignment among groups interested in this field, we propose a research framework to further understanding of vigorous intermittent lifestyle physical activity (VILPA). This framework comprises four pillars aimed at the development of: (a) an empirical definition of VILPA, (b) methods to reliably and accurately measure VILPA, (c) approaches to examine the short and long-term dose-response effects of VILPA, and (d) scalable and acceptable behavioural VILPA-promoting interventions.